Health Library

A tibial fracture is a break in the larger bone or shin bone (tibia) in the lower leg.

What are the causes?

A break in the shinbone is caused by an injury to the leg. The injury may come from:

1. A fall.
2. Contact sports.
3. A motor vehicle crash.

What increases the risk?

1. Playing sports
2. Activities that involve jumping.
3. Activities that involve doing the same movements over and over, such as long-distance running.

What are the signs or symptoms?

1. Pain.
2. Swelling.
3. Bruising.
4. Not being able to walk on the leg.
5. The leg having a shape that is not normal (deformity).
6. Numbness in your foot. There may also be prickling and tingling. This may be a sign of nerve injury.

How is this diagnosed?

A break in the shinbone may be diagnosed based on:

1. Your child's symptoms and medical history.
2. A physical exam.
3. Imaging tests, such as X-ray, CT scan, or MRI.
4. In toddlers and infants, an X-ray may not show the fracture. X-rays will be repeated days or weeks later.

How is this treated?

Treatment may include:

1. Wearing a cast or splint while the bone heals. Younger children may have a cast or splint that covers their entire leg.
2. Using crutches to avoid putting weight on the leg.
3. Doing exercises to regain movement and strength. This may start after the cast or splint is removed.
4. If parts of the bone moved out of place:
5. The bones may be moved to the right position before being put on the cast or splint.
6. Your child may have surgery to repair the bone. This may include placing metal rods, plates, or screws.

Follow these instructions at home:

If your child has a splint that can be taken off:

1. Have your child wear the splint as told. Take it off only if your child's health care provider says you can.
2. Check the skin around it every day. Tell the provider if you see problems.
3. Loosen the splint if your child's toes tingle, are numb, or turn cold and blue.
4. Keep the splint clean and dry.

If your child has a cast that can't be taken off:

1. Do not let your child put pressure on any part of the cast until it's hard. This may take a few hours.
2. Do not let your child stick anything inside it to scratch their skin. Doing this can lead to infection.
3. Check the skin around the cast every day. Tell the provider if you see problems.
4. It's OK to put lotion on dry skin around the cast.
5. Keep the cast clean and dry.

Bathing

1. Do not let your child take baths, swim, or use a hot tub until you're told it's OK. Ask how to bathe your child.
2. If the splint or cast is not waterproof:
3. Do not let it get wet.
4. Cover it when your child takes a bath or shower. Use a cover that doesn't let ay water in.

Managing pain, stiffness, and swelling

1. Use ice or an ice pack as told.
2. If your child has a splint or brace that you can take off, remove it only as told.
3. Place a towel between your child's skin and the ice, or between your child's cast and the ice.
4. Leave the ice on for 20 minutes, 2–3 times a day.
5. If your child's skin turns red, take off the ice right away to prevent skin damage. The risk of damage is higher if your child can't feel pain, heat, or cold.

Also, your child should:

1. Move their toes often to reduce stiffness and swelling.
2. Raise their leg above the level of their heart while they're sitting or lying down. Use pillows as needed.

Activity

1. Do not let your child stand or walk on the injured leg until you're told it's OK. Have them use crutches, a scooter, or a wheelchair.
2. Have your child exercise as told.
3. Ask what things are safe for your child to do at home. Ask when your child can go back to school or work.

Medicines

1. Give your child medicines only as told.
2. You may need to take steps to help treat or prevent trouble pooping (constipation), such as:
3. Giving medicines to help your child poop.
4. Giving foods high in fiber, like beans, whole grains, and fresh fruits and vegetables.
5. Having your child drink more fluids as told.
6. Ask the provider if it's safe for your child to drive or use machines while taking their medicine.

General instructions

1. Do not let your child smoke, vape, or use nicotine or tobacco.
2. Do not smoke or vape around your child.
3. Ask when it's safe for an older child to drive if the child has a cast or splint on their leg.
4. Keep all follow-up visits. The provider needs to make sure your child is healing.

Contact a health care provider if:

1. Your child has pain that gets worse or doesn't get better with medicine.
2. Your child has redness or swelling that gets worse.
3. Your child has numbness or tingling in the toes or foot.

Get help right away if:

1. Your child's foot or toes feel cold or turn blue, even after loosening the splint.
2. Your child has very bad pain.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.